With the continued concern of e-cigarette use among youth, it is crucial to understand risk factors that may be associated with susceptibility to e-cigarette use and current use. Tobacco retailer placement and youth exposure to advertisements and products through brick-and-mortar locations may be associated with increased e-cigarette use and susceptibility among youth, yet youth exposure to tobacco retail locations as a potential influential factor for tobacco use is largely under-researched. The purpose of this study is to explore the potential relationship between tobacco retailer proximity/density around Kentucky elementary, middle, and high schools, and students' perceptions of harm, perceived norms, susceptibility to, and use of e-cigarettes. This study used a cross-sectional design combining self-reported survey data and geospatial analysis. Participants (N = 7,823) consisted of a convenience sample of students from 106 Kentucky elementary, middle, and high schools which participated in a tobacco education program between September 2023 and May 2024. Items assessing e-cigarette use, susceptibility, perceptions, and perceived norms were measured through an online survey. ANOVA tests were used to compare responses of elementary, middle, and high school students. Chi-squared tests were used to compare measures in proximity and density groups. High density of tobacco retailers around schools was positively associated with greater rates of susceptibility and lower perceived risks of e-cigarette use compared to lower density groups (p < 0.05). Students within one mile of a retailer were more likely to report positive perceptions of e-cigarettes compared to students further than one mile (p < 0.05). Greater density and proximity of tobacco retailers around schools were associated with higher e-cigarette use, susceptibility, and positive perceptions of use. Identifying areas of influence for youth e-cigarette use, and implementation of appropriate restrictions may sufficiently decrease youth exposure to tobacco products and advertising, lowering future health inequalities among young people in Kentucky.
Lung cancer and sepsis are major contributors to morbidity and mortality worldwide. Their coexistence represents a significant clinical challenge, as patients with lung cancer may be at increased risk of developing sepsis because of cancer-related immune dysfunction, treatment-related immunosuppression, and frequent healthcare exposure. Sepsis in these patients is associated with poor outcomes, increased health care utilization, and higher mortality rates. We conducted a retrospective analysis of death certificates from the Centers for Disease Control and Prevention (CDC) WONDER database to evaluate mortality associated with the co-occurrence of lung cancer and sepsis among adults aged ≥ 45 years in the United States from 1999 to 2024. Age-adjusted mortality rates (AAMRs) and annual percent changes (APCs) were calculated and stratified by year, sex, race/ethnicity, census region, state, and metropolitan status. AAMR increased from 1.6 to 2.0 per 100,000 population between 1999 and 2024. Among males, the AAMR increased from 2.3 in 1999 to 2.4 in 2024, while among females, it rose from 1.1 to 1.6 over the same period. Racial disparities were evident, with non-Hispanic Black or African American adults experiencing the highest AAMR (2.6). Regionally, the South had the highest mortality burden (AAMR 2.2), while Kentucky and Mississippi reported the highest state-level rates (3.98 and 3.14, respectively). Mortality rates were higher in non-metropolitan areas (AAMR 1.9) compared with metropolitan areas (1.7). Mortality associated with coexisting lung cancer and sepsis has increased over time, with notable disparities across demographic and geographic groups. These findings highlight the need for targeted public health strategies and improved access to care to reduce mortality in high-risk populations.
Despite naloxone's proven effectiveness in reversing opioid poisoning, receipt rates among the high-risk Medicaid population remain insufficient and the patient- and system-level characteristics associated with this gap are poorly understood. To describe the patient-and system-level characteristics associated with a naloxone prescription fill within 7 days of a non-fatal opioid poisoning among Medicaid beneficiaries. Using the Merative™ MarketScan® Multi-State Medicaid Database (2018-2022), we identified adult (≥18 years) beneficiaries with a non-fatal opioid poisoning. The primary outcome was a naloxone prescription claim within 7 days of the index poisoning. Multivariable logistic regression characterized associations between beneficiary characteristics and naloxone prescription fill. Robustness was assessed using last-event indexing RESULTS: Among 64,332 beneficiaries (mean [SD] age 38.6 [12.1] years), 2,590 (4.0%) received naloxone within 7 days. After adjustment, the odds of naloxone receipt were higher among Black (aOR 1.26, 95% CI 1.13-1.41) and Hispanic (aOR 1.22, 95% CI 1.01-1.47) beneficiaries relative to White, and among those with a prior mental health disorder (aOR 1.23, 95% CI 1.12-1.34). Greater comorbidity was associated with higher odds relative to a Charlson score of 0 (1-2: aOR 1.14, 95% CI 1.03-1.25; 3-4: aOR 1.23, 95% CI 1.05-1.45 and 1.20, 95% CI 1.01-1.42). Odds were lower among older beneficiaries, particularly those aged ≥65 years (aOR 0.33, 95% CI 0.22-0.48), and those in capitated (managed care) plans (aOR 0.57, 95% CI 0.53-0.62). Findings were largely consistent across the sensitivity analysis. Prior opioid poisoning, more common under last-event indexing (≥1 episode in 65.5%, vs 0.8%), was not associated with naloxone receipt (aOR 1.04, 95% CI 0.96-1.11). Naloxone remains under-prescribed for Medicaid beneficiaries after non-fatal opioid poisoning, with receipt varying by demographic, clinical, and insurance characteristics. Timely naloxone should be offered to all in need, regardless of patient or system characteristics.
Background: Gliomas are primary malignant brain tumors. Among them, grade IV astrocytomas represent the most aggressive form with limited treatment options and a poor prognosis. There is a critical need for reliable prognostic biomarkers to predict patient outcomes. Methods: In this study, we evaluated the prognostic roles of glycomics in predicting outcomes of patients with glioma. To address this need, we collected a cohort of 86 patients and conducted N-linked glycomics analysis using matrix-assisted laser desorption/ionization mass spectrometry on a tissue microarray comprising 78 gliomas and 8 controls. We performed survival analyses and machine-learning-based predictive modeling to evaluate the prognostic roles of glycomic features. Results and Conclusion: Glycomic features alone displayed strong performance in classifying mortality status, achieving a mean area under the receiver operating characteristic curve (AUROC) value of 0.880 and a mean area under the precision-recall curve (AUPRC) value of 0.925, and demonstrating consistent prognostic value in survival analyses with a mean concordance index of 0.759 across repeated cross-validation. Glycomic features also showed strong performance in predicting the incidence of seizure status, with a mean AUROC value of 0.778 and a mean AUPRC value of 0.766. Additionally, top-ranked glycans from machine-learning models can effectively stratify patients based on their survival outcomes, demonstrating their potential role as prognostic biomarkers.
The pervasive penetration of social media is reshaping the generative logic and communication pathways of health anxiety, which is significantly impacting public mental health and individual behavior. This study aimed to examine the topic threads of health anxiety discussions on Sina Weibo as well as the threat and efficacy elements contained in the health-related messages through the Extended Parallel Process Model (EPPM) framework. A total of 138,587 social media posts related to health anxiety were collected using keyword combination of "health" AND ("worry" OR "concern" OR "anxiety") on the Weibo open API. Latent Dirichlet Allocation (LDA) model procedures were applied to identify the main topics in health anxiety discussions. Moreover, 1,480 most popular posts ranked by "Like" clicks were selected for manual textual analysis. Based on the Extended Parallel Process Model (EPPM), four dimensions-severity, susceptibility, self-efficacy, and response efficacy-were used as the coding framework for content analysis to systematically ascertain the topic structure, information characteristics and information engagement with health anxiety Weibo discussions. Discussions of health anxiety cover a wide range of topics. The most prominent topic is positive living and health ideals (intensity = 0.4456), and other major topics include sleep disorders and mental health, adolescent mental health education and social adaptation, healthy lifestyle and self-management. There is a noticeable imbalance between elements of threat and efficacy in health anxiety discussions. Threat information dominates health anxiety discussions, with severity being the most prevalent component (73.24%). Conversely, efficacy information is much less featured, particularly regarding response efficacy (16.15%). Higher perceived threat levels in health anxiety discussions correlate with reduced engagement (fewer likes), whereas greater efficacy information levels are associated with increased engagement (more likes). Health anxiety discussions on social media exhibit a generative logic characterized by thematic threads emphasizing positive confidence-building, proactive measures, ailment-specific guidance, and subgroup-focused solution tips. Users' conception of health anxiety reflects a contradictory pattern of "high threat-low efficacy", wherein information about health threats is far more prevalent than information about self-efficacy. These findings show that EPPM-related threat and efficacy elements are distributed in user-generated Weibo discussions.
One in four older adults report experiencing current anxiety or depression, yet fewer than 20% access formal mental health care services. To better understand this treatment gap, the present study investigated the influence of sociocultural factors (e.g., close others stigma, self-stigma, internalized ageism, emotional control, self-reliance, provider cultural humility, logistical barriers, psychological distress, social support) on professional mental health help-seeking intention among older adults (age ≥ 55) in the United States, using the Integrated Behavioral Model of Mental Health Help-Seeking. Structural equation modeling was used to determine which of these sociocultural factors demonstrated an independent indirect effect on intention, as well as the Integrated Behavioral Model of Mental Health Help-Seeking mechanisms (attitude, perceived norm, personal agency) that mediate these indirect effects. Self-stigma of seeking help, perceived provider cultural humility, and psychological distress demonstrated the clearest connection with intention via the mediators of attitude and/or perceived norm. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
The tear film lipid layer (TFLL) is an outermost component of the tear film. The TFLL plays a critical role in maintaining ocular hydration, protecting the corneal surface, and preserving visual clarity. By stabilizing the tear film and minimizing evaporative water loss, the TFLL helps to prevent tear film breakup. Disruptions in the structural organization or chemical composition of the TFLL can compromise its function and cause dry eye disease (DED). Molecular-level mechanisms governing the TFLL behavior remain poorly understood. This study presents large-scale, atomistic molecular dynamics (MD) simulations of TFLL incorporating physiological lipid compositions. Model accuracy was validated by comparison to previously reported experimental properties. The model exhibited reasonable densities and lipid ordering, as previously observed in spectroscopic studies. Shear thinning behavior was observed, consistent with known viscoelastic characteristics. Lateral diffusion coefficients were in reasonable agreement with experimental data. The resulting atomistic representation is a reproducible, high-resolution molecular model that will enable future investigations into TFLL properties. The model structure provides mechanistic insights into tear film structuring and establishes a foundation for future computational work that can inform the development of more effective, long-lasting therapies for DED.
Alzheimer's disease (AD) dementia in Down syndrome (DS) occurs at predictable ages. It is unclear whether age can differentiate across AD stages (amyloid positivity, tau positivity, mild cognitive impairment [MCI], dementia). Using data from the Alzheimer's Biomarker Consortium-Down Syndrome, we analyzed how well age differentiated stage using receiver operating characteristic curves. We compared areas under the curve (AUC) for age to AUCs for imaging, biofluid, cognitive, motor, and behavioral variables. Sample varied by stage and variable. Up to 148 variables and 461 participants were analyzed. Age effectively differentiated amyloid positivity, tau positivity, and MCI (AUCs > 0.85) but poorly discriminated MCI from dementia (0.588). No variable was better than age in distinguishing stages, except for MCI/dementia. Our results show that age alone is effective at staging DS AD. Age is the most reliable correlate of amyloid, tau status, and cognitive impairment in DS and could screen for future clinical trials.
Early identification of Alzheimer's disease and related dementias (ADRD) remains limited by specialized tests and late-stage diagnosis. The Zero-burden Risk Assessment (ZeBRA) is an AI-driven score that predicts incident ADRD up to a decade before diagnosis using only routine electronic health record (EHR) data, without laboratory tests, imaging, or questionnaires. Trained on 487,989 cases and 12,483,718 controls from nationwide U.S. insurance claims and validated on held-out National samples and two independent cohorts, ZeBRA achieved AUC = 0.93 and 0.83 in the 50+ cohort for 1-year and 10-year horizons, respectively, with positive likelihood ratios exceeding 10 in the National 50+ held-out cohort at 95% specificity and stable discrimination over time. Performance was consistent across age, sex, race, and ethnicity subgroups. In a prospective feasibility pilot, higher ZeBRA scores showed concordance with lower Montreal Cognitive Assessment (MoCA) scores, indicating greater cognitive impairment (R = -0.78, 95% CI: -0.94 to -0.37). Compared with prior EHR-based models, ZeBRA provides superior accuracy, cross-site generalizability, and noise-corrected interpretability via our novel Λ-OR attribution metric. Scalability and low burden suggest application in population-level early detection and presymptomatic trial enrichment.
Widowhood in later life is a critical, yet understudied, issue in Bangladesh, where patriarchal norms and limited social welfare infrastructure exacerbate the vulnerabilities of older women. This exploratory qualitative study examined the psychosocial challenges faced by 20 older widows from both rural and urban areas of Bangladesh. Using a basic interpretative approach, data were collected in person via semi-structured interviews. The findings of the study reveal three themes: (1) being trapped in a cycle of poverty, marked by malnutrition, inadequate healthcare, and financial dependency; (2) experiences of exclusion and neglect within families and communities, resulting in diminished dignity and social isolation; and (3) repeated harms, including verbal abuse, emotional mistreatment, and, in some cases, sexual harassment. These challenges reflect multiple, interconnected psychological issues that have implications for the well-being of older widows in Bangladesh. The study underscores the urgent need for social protection policies for older widows, improved access to healthcare and mental health services for them, and mechanisms that ensure their inheritance and property rights. This study contributes to global gerontological scholarship by documenting the day-to-day challenges of older widows in Bangladesh. Findings point to potential policy implications to advance widow welfare in resource-constrained settings.
Retinomorphic hardware, inspired by the human visual system, integrates sensing and preprocessing within the same device and requires optoelectronic pixels capable of electrically encoding photoresponse into antagonistic ON and OFF pathways. Existing approaches generally rely on gated architecture or high-voltage polarization switching (typically >1 V), which increases circuit complexity and dynamic power consumption for device reconfiguration. Here, we report a vertical two-terminal organic optoelectronic design based on a single-layered-doped conducting polymer, n-doped poly(benzodifurandione) (n-PBDF), with asymmetric electrodes. Leveraging electrode asymmetric work function and polymer doping engineering, the proposed device achieves continuous analog tuning of photoresponse polarity from negative to positive at low operational voltage (<0.2 V), enabling the emulation of antagonistic visual encoding. The n-PBDF-based device also exhibits robust reversible negative-to-positive photoresponse switching for 106 cycles and stable retention for 78 days under ambient conditions. These characteristics, together with its structurally compact pixel, enable crossbar array-level in-sensor image processing, including edge enhancement and trainable image classification. The results establish a compact organic hardware primitive for low-voltage, reconfigurable, retina-inspired vision systems.
To mitigate insulin response and laminitis risk in insulin dysregulated (ID) horses, current management focuses on restricting pasture exposure and feeding low nonstructural carbohydrate (NSC) rations. Further research is needed to determine whether grazing muzzles, through reducing intake, can improve metabolic control during turnout. To evaluate how utilizing grazing muzzles in ID horses influences insulin response to fresh forage over a 10h summer grazing period. Replicated 2 × 2 crossover study, with nine ID horses. Each horse received each treatment twice (control and grazing muzzle). During acclimation and the 2-week collection period, horses were group kept with ad libitum access to pasture and water. On each of the four sampling days, peripheral blood, heart rate, ambient temperature (AT), and pasture samples were measured or collected every 2 hours for a 10h period (0900-1900). Plasma insulin, glucose, and pasture NSC were determined. Pasture NSC ranged from 6.0%-13.8% DM and AT 23-34°C. The insulinemic response was affected by treatment (p = 0.002), time (p = 0.019) and their interaction (p < 0.001). Peak insulin was greater in control (45.59±21.07µIU/mL) than muzzled (24.31±14.37µIU/mL) horses (p < 0.001), but neither were high. Overall glycemic response was significantly affected by time (p = 0.022), but not treatment (p = 0.087). Heart rate was numerically greater in control than muzzled horses at all timepoints. Grazing muzzles may be an effective management strategy helping reduce insulin responses in ID horses. However, changes in pasture NSC and individual animal variation, emphasize importance of repeated monitoring.
Despite the recognition of substance use and sex work as public health issues, the intersection of these areas, especially within the rural US, is an area of special importance. The Rural Opioid Initiative comprises of eight research cohorts spanning 10 states and 65 rural US counties. Between 1/2018-3/2020, individuals who reported past 30-day substance injection or opioid misuse were recruited. Analyses were restricted to people who use drugs (PWUD) who reported trading "vaginal or anal sex for drugs, money, housing, or other things you need" in the past 30 days. We analyzed cross-sectional associations between injection drug use and sexual behaviors associated with hepatitis C virus (HCV)/HIV infection transmission, access to harm reduction, and HCV status among PWUD and engaged in sex work in rural US areas. Of the 2045 participants, 9% (n=180) reported engagement with sex work, with just over half being women (58% [n=104]). In adjusted models, people who engaged in sex work, compared to PWUD who did not, had higher prevalence ratios of past 30-day receptive syringe sharing (adjusted prevalence ratio [aPR]=1.69, 95% Confidence Interval [95%CI]=1.44-1.98), practice of multiple injections per injection episode (aPR = 1.28, 95% CI = 1.15-1.43), practice of syringe mediated drug sharing (aPR=1.50, 95% CI=1.32-1.71), condomless sex (aPR=1.62, 95% CI=1.48-1.77) and condomless sex with someone who injects drugs (aPR=2.05, 95% CI=1.76-2.39). PWUD engaged in sex work were less likely to report easy condom access (aPR=0.88, 95% CI=0.80-0.96), while no significant differences were observed for most other harm reduction access measures. PWUD engaged in sex work in the rural US had higher likelihood of injection drug use and sexual behaviors associated with HCV/HIV infection transmission, while having lower use of and access to condoms. This study emphasizes the importance of ensuring affordable access to condoms within the context of harm reduction services, especially given the limited access to health care and supportive services, particularly in rural communities.
Objective: Psychological distress among United States (US) adults following the COVID-19 pandemic remains incompletely characterized. To address this gap, we compared the prevalence of psychological distress during and after the pandemic with pre-pandemic levels using nationally representative data. Methods: We analyzed six iterations of the Health Information National Trends Survey. Psychological distress was measured using the Patient Health Questionnaire-4. Adjusted prevalence ratios (aPRs) comparing early, late, and post-pandemic periods with the pre-pandemic period were estimated using weighted logistic regression models accounting for key demographic and geographic characteristics. The data were collected January 2018 to September 2024 in the US. Results: Among 25,459 respondents, the prevalence of clinically meaningful psychological distress was 12.8% during the pre-pandemic period, 14.7% during the early pandemic period, 14.0% during the late pandemic period, and 14.9% during the post-pandemic period. Compared with pre-pandemic levels, distress prevalence was similar during the early pandemic (aPR = 1.06; 95%CI = 0.83,1.36) and late pandemic (aPR = 1.09; 95%CI = 0.94,1.27) but higher post-pandemic (aPR = 1.16; 95%CI = 1.02,1.32). Increases were most evident for anxiety-related symptoms and among males, younger adults, and college graduates. Conclusions: Psychological distress among US adults was higher in 2024 than before the pandemic, underscoring the need for sustained mental health surveillance, prevention strategies, and resource allocation.
Secular trends in body height reflect changes in living conditions and population health, while socioeconomic gradients in height indicate persistent inequalities in growth opportunities. The aim of this study was to examine secular trends and socioeconomic variation in height among young adult Polish men between 1965 and 2023. Data included nationally representative surveys of Polish military conscripts conducted in 1965, 1986, 1995, 2001, 2010, and 2023 (N = 137 551). Body height was measured and socioeconomic status (SES) was estimated by questionnaire using four indicators: urbanization level (city, town, village), mother's and father's education (university, secondary, vocational, elementary), and family size (1-2, 3, and 4 or more children). Overall SES was estimated with principal component analysis and divided into three categories: high, medium, low. Statistical analyses included one-way and two-way ANOVAs with Tukey post hoc tests for unequal samples; effect sizes were expressed as partial eta squared (η2). Mean height increased significantly across successive surveys (p < 0.0001), with the largest gains between 1965 and 1986. The secular trend progressively decelerated, with minimal increases observed between 2010 and 2023. Socioeconomic variation in height declined over time but remained statistically significant for most SES indicators in 2023, except for urbanization (p > 0.05). The reduction in differences was largely due to greater height gains among lower SES groups after 2001. Note, however, effect sizes for all SES factors were small: partial η2 values from 0.008 to 0.012, and medium for the year of survey: η2 values from 0.040 to 0.125. The continued but slowing increase in body height suggests that Polish men are approaching population growth potential. However, persistent socioeconomic differences in terms of parental education and family size imply that individuals from lower socioeconomic strata still retain potential for biological catch-up.
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We report the synthesis and characterization of a series of isomeric indacenodithiophenes (iso-IDTs) bearing various ethynyl substituents at the apical carbons. Absorption spectroscopy, cyclic voltammetry, and density functional theory (DFT) calculations were performed to investigate the electronic properties of these compounds. Notably, analogues with reduced steric protection (i.e., trimethylsilyl, adamantyl) were also successfully isolated and investigated. Computed nucleus-independent chemical shifts and ring current plot analyses reveal that iso-IDTs display reduced antiaromatic character compared to indenofluorene (IF) and the previously reported syn- and anti-fused IDT isomers, suggesting that the π-bond arrangement within the indacenodithiophene π-system can be leveraged for tuning their optoelectronic properties.
To determine if in vitro α/β estimates agree with clinical values, and if there are discrepancies, how they potentially impact clinical outcomes. A total of 234 clinical and in vitro estimates of α/β for prostate, breast, and head and neck cancer were collected across 108 studies. Statistical tests and correlation analysis were performed to determine a pattern between clinical and experimental values. Bootstrapped Monte Carlo sampling was applied to determine the underlying distribution of α and α/β values, comparing clinical and in vitro distributions. The Poisson tumor control probability (TCP) model was applied to determine the potential differences between clinical and experimental α and α/β. For prostate cancer, logistic regression was used to fit TCP models to published patient outcome data. Applying a 2-population TCP model, lower-risk cohorts and high-risk subpopulations were used to determine the influence of tumor heterogeneity on α/β. For prostate cancer, the median in vitro α/β estimate was 3.8 Gy and median clinical estimate was 2.3 Gy. For breast cancer, clinical and in vitro estimates were 3.9 Gy and 3.6 Gy, respectively. Head and neck clinical and in vitro doses were 9 Gy and 14 Gy, respectively. Correlation analysis only found a correlation with α/β and organ type. TCP curves for in vitro and clinical estimates demonstrated significant differences in the shapes of the curves they generated. Applying the 2-population TCP model to prostate cancer outcomes data gave better agreement with in vitro α/β estimates in the case of medium-risk patient groups at a value of about 4 Gy. The high-risk group predicted a larger and more radioresistant subpopulation, with an α/β of 2.3 Gy and a fraction of 0.44. Despite some prominent claims, no evidence was found supporting an agreement between in vitro and in vivo α/β estimates. Statistically significant differences existed between in vitro and clinical estimates, especially in the estimation of the α parameter. α values tend to be larger for in vitro estimates. Therefore, in vitro estimates of α/β cannot directly predict clinical radiosensitivity estimates. However, tumor heterogeneity may play a significant role in the clinical environment that is not seen in laboratory settings. Accounting for heterogeneity can provide more reasonable fits to patient data, and more complex models may help to more accurately correlate in vitro measurements with clinical values.
Binary metal oxide nanoparticles (biMO-NPs) combining transition and main-group metals with well-organized atomic architectures have unique potential as robust and economical heterogeneous catalysts. Herein, metal oxide nanoparticles (CoAlxOy) using cobalt and aluminum were synthesized, and their structure, morphology, and chemical composition were investigated using various characterization techniques. The biMO-NPs, which had a Gaussian-type size distribution (∼6 nm), were assembled on plain silicon substrates modified chemically with linker molecules bearing suitable end groups. Surface analysis revealed an ordered, uniform, close-packed arrangement of biMO-NPs forming a monolayer architecture with nanoscale thickness (∼12 nm), high surface uniformity, and negligible defects. The nanoparticle monolayer film (NP-MF) was employed as a catalyst to grow carbon nanotube (CNT) forests via the thermal chemical vapor deposition (CVD) method, similar to those grown from catalyst thin films deposited by physical vapor deposition. Structural characterization confirmed the growth of a dense, uniform, high-quality vertically aligned carbon nanotube (VA-CNT) forest with a length of ∼125 µm, which is comparable to the VA-CNTs grown from expensive thin films. Thus, CNT growth was successfully catalyzed by the biMO-NPs, highlighting a simple and inexpensive alternative for catalyst deposition. In this innovative wet-chemistry approach, the catalyst and catalyst support are combined within a single nanoparticle before NP-MF assembly. Interestingly, this approach provides a scalable and cost-effective pathway for CNT growth, eliminating the need for expensive thin deposition techniques.
Mastectomy skin flap necrosis remains a major complication in implant-based breast reconstruction due to inadequate tissue blood flow. Existing diagnostic technologies are limited by shallow depth sensitivity, dye-related risks, contact requirements, and an inability to continuously assess blood flow. We aimed to translate a noncontact, dye-free, depth-sensitive speckle contrast diffuse correlation tomography (scDCT) technique to a clinically relevant porcine skin flap model for assessing flap blood flow and viability. The scDCT system was optimized to image blood flow over 7 days in four porcine skin flaps including sham, implant, half necrosis, and full necrosis (FN). Measurements were compared with indocyanine green angiography (ICG-A) as a reference standard. scDCT enabled longitudinal monitoring of flap blood flow, revealing significant flow differences among flap types and over time. FN flaps consistently exhibited the most severe flow impairment, whereas other flap types showed partial or complete recovery over time, distinguishing nonviable from viable tissue. scDCT measurements demonstrated moderate to strong correlations with ICG-A across time points. The findings support scDCT as a promising perioperative imaging modality for improving flap necrosis risk stratification and surgical decision-making, with future work focused on large-scale validation and clinical translation.